8th Edition of the AJCC Gastric Cancer Staging System

T category definitions, gastric cancer

TX Primary tumor cannot be assessed

T0 No evidence of primary tumor
Tis Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria
T1 Tumor invades lamina propria, muscularis mucosae, or submucosa
T1a Tumor invades lamina propria or muscularis mucosae
T1b Tumor invades submucosa
T2 Tumor invades muscularis propria
Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or
adjacent structures. T3 tumors also include those extending into the gastrocolic or
T3
gastrohepatic ligaments, or into the greater or lesser omentum, without perforation of the
visceral peritoneum covering these structures
T4 Tumor invades serosa (visceral peritoneum) or adjacent structures
T4a Tumor invades serosa (visceral peritoneum)
Tumor invades adjacent structures such as spleen, transverse colon, liver, diaphragm,
pancreas, abdominal wall, adrenal gland, kidney, small intestine, and retroperitoneum

T4b Tumor invades adjacent structures such as spleen, transverse colon, liver, diaphragm,
pancreas, abdominal wall, adrenal gland, kidney, small intestine, and retroperitoneum

N category definitions, gastric cancer

NX Regional lymph node(s) cannot be assessed

N0 No regional lymph node metastasis
N1 Metastasis in 1 to 2 regional lymph nodes
N2 Metastasis in 3 to 6 regional lymph nodes
N3 Metastasis in 7 or more regional lymph nodes

M category definitions, gastric cancer

M0 No distant metastasis
M1 Distant metastasis
Anatomic stage/prognostic groups, gastric cancer

Stage I T1, T2, N0 M0

Stage IIA T1, T2 N1, N2, N3 M0

Stage IIB T3, T4a N0 M0

Stage III T3, T4a N1, N2, N3 M0

Stage IV T4b Any N M0

Stage IV Any T Any N Any M1